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Akihiro Ishibazawa, Taiji Nagaoka, Atsushi Takahashi, Tsuneaki Omae, Tomofumi Tani, Kenji Sogawa, Harumasa Yokota, Akitoshi Yoshida; Clinical evaluation of vascular lesions in diabetic retinopathy using optical coherence tomography angiography . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3339.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the ability of optical coherence tomography angiography (OCTA) to visualize clinical fundus findings in patients with diabetic retinopathy (DR).
Forty-seven eyes of 25 patients with DR were scanned using a high-speed 840-nm-wavelength spectral-domain optical coherence tomography (OCT) instrument (RTVue XR Avanti, Optovue Inc., Fremont, CA). Blood flow was detected using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm, and three-dimensional macular or optic disc angiography was computed. Color fundus and fluorescein angiography (FA) images also were obtained in all eyes and compared to the en-face SSADA images for the ability to visualize microaneurysms (MAs), retinal nonperfusion (RNP), and neovascularization (NV).
Ninety-three percent of MAs detected by FA in 42 eyes appeared as focally dilated saccular or fusiform capillaries in the en-face SSADA images. The MAs were located in the superficial vascular plexus (SVP) (30.3%) or the deep capillary plexus (DCP) (69.7%). The RNP visualized by FA appeared as lesions with no or sparse capillaries in the SSADA images. Measurement of the RNP area near the macula in seven eyes showed that the RNP area in the SVP (mean ± standard error of the mean [SEM], 3.67 ± 1.69 mm2) was larger than in the DCP (mean ± SEM, 3.02 ± 1.44 mm2). The NV at the disc seen in four eyes on FA images and had marked fluorescein leakage in the early phase. The vascular structure of the NV was clearly visualized in the SSADA images. NV regression and regeneration were quantified in an eye treated with antivascular endothelial growth factor therapy.
OCTA can clearly visualize MAs and RNP and enables evaluation of the retinal capillaries layer by layer. Quantitative information on NV also can be obtained. OCTA may be clinically useful to evaluate the microvascular status and therapeutic effect of treatments for DR.
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